American Society of Biomechanics Clinical Biomechanics Award 2012: plantar shear stress distributions in diabetic patients with and without neuropathy.
American Society of Biomechanics Clinical Biomechanics Award 2012: plantar shear stress distributions in diabetic patients with and without neuropathy.
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DOI：
10.1016/j.clinbiomech.2013.11.003
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发表时间：
2014-02
期刊：
影响因子：
--
通讯作者：
Yavuz M
中科院分区：
文献类型：
--
作者：
Yavuz M
糖尿病足溃疡的确切病理仍有待解决。有证据表明，足底剪切力在糖尿病溃疡中起主要作用。不幸的是，只有少数手稿存在的临床意义的足底剪切。本研究的目的是比较三组患者的整体和区域足底应力峰值;糖尿病患者神经病变，糖尿病患者无神经病变和健康对照组。招募了14名糖尿病神经病变患者，14名非神经病变糖尿病对照和11名非糖尿病对照受试者。受试者走在一个定制的应力板，量化足底压力和剪切。分析了四个应力变量：峰值压力、峰值剪切、峰值压力-时间和剪切-时间积分。糖尿病神经病变组的峰值剪切力（p=0.039）、剪切力-时间积分（p=0.002）和压力-时间积分（p=0.003）的总体峰值显著更高。与两个对照组相比，糖尿病神经病变患者的局部峰值剪切应力和剪切时间积分也显著更高，特别是在拇趾和中央前足。局部峰值压力和压力-时间积分在前足内侧和外侧三组之间有显著差异。足底剪切力和剪切时间积分幅度升高糖尿病患者周围神经病变，这表明这些因素在溃疡的潜在临床意义。人们认为，足底剪切的进一步研究将导致更好地理解溃疡病理力学，这反过来将有助于研究人员开发更有效的预防设备和策略。
The exact pathology of diabetic foot ulcers remains to be resolved. Evidence suggests that plantar shear forces play a major role in diabetic ulceration. Unfortunately, only a few manuscripts exist on the clinical implications of plantar shear. The purpose of this study was to compare global and regional peak plantar stress values in three groups; diabetic patients with neuropathy, diabetic patients without neuropathy and healthy control subjects. Fourteen diabetic neuropathic patients, 14 non-neuropathic diabetic control and 11 non-diabetic control subjects were recruited. Subjects walked on a custom-built stress plate that quantified plantar pressures and shear. Four stress variables were analyzed; peak pressure, peak shear, peak pressure-time and shear-time integral. Global peak values of peak shear (p=0.039), shear-time integral (p=0.002) and pressure-time integral (p=0.003) were significantly higher in the diabetic neuropathic group. Local peak shear stress and shear-time integral were also significantly higher in diabetic neuropathic patients compared to both control groups, in particular, at the hallux and central forefoot. Local peak pressure and pressure-time integral were significantly different between the three groups at the medial and lateral forefoot. Plantar shear and shear-time integral magnitudes were elevated in diabetic patients with peripheral neuropathy, which indicates the potential clinical significance of these factors in ulceration. It is thought that further investigation of plantar shear would lead to a better understanding of ulceration pathomechanics, which in turn will assist researchers in developing more effective preventive devices and strategies.
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影响因子：
16.2
作者：
Bloomgarden, Zachary T.
通讯作者：
Bloomgarden, Zachary T.
影响因子：
9.6
作者：
CTERCTEKO, GC;DHANENDRAN, M;LEQUESNE, LP
通讯作者：
LEQUESNE, LP
影响因子：
6.5
作者：
GOLDBLUM, RW;PIPER, WN
通讯作者：
PIPER, WN
影响因子：
6.5
作者：
MACKENZIE, IC
通讯作者：
MACKENZIE, IC
影响因子：
16.2
作者：
Boulton AJ;Armstrong DG;Albert SF;Frykberg RG;Hellman R;Kirkman MS;Lavery LA;Lemaster JW;Mills JL Sr;Mueller MJ;Sheehan P;Wukich DK;American Diabetes Association;American Association of Clinical Endocrinologists
通讯作者：
American Association of Clinical Endocrinologists